| NPI | 1861805020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE RENEE SIMON Lpc 254-415-9112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 18023) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 18023) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |